NHS Clinical Commissioners (NHSCC) have published a report showing how Clinical Commissioning Groups (CCGs) in England’s Core Cities are taking up the challenge set out in the Five Year Forward View and transforming the way in which healthcare is delivered to the benefit of their local population.

The Core Cities Network is a peer-led network representing CCGs from the eight core cities in England outside London (Nottingham, Leeds, Sheffield, Birmingham, Bristol, Newcastle, Liverpool and Manchester). It is hosted by NHS Clinical Commissioners, the independent collective voice of CCGs. Their purpose is to improve the health outcomes of populations that live in complex city environments.

The report shows how commissioners in these core cities are addressing health challenges. It also highlights how clinically-led commissioning is making it possible to deliver healthcare focused on the needs of specific populations and that the core cities are at the forefront of the transformational change required by the Five Year Forward View.

Innovation

The key themes in the report are:

• Ensuring equity of care across diverse populations
• Partnership working
• Improving wellbeing
• Challenging healthcare

A range of innovative new approaches are featured in the report from 11 case studies using information obtained from 10 CCGs, these include:

• Devolution in Manchester;
• A large scale social prescribing programme in Newcastle, where payments are made to the provider based on outcomes;
• A scheme ensuring patients in Birmingham receive the same standard of care from their GP regardless of which practice in the city they attend;
• A GP surgery based clinic to support women affected by female genital mutilation in Bristol.

The report also sets out changes that could be made centrally to support CCGs including ensuring genuine independence for local commissioning, giving flexibility when it comes to contracting services, and improving data sharing.

Leadership

Dr Tim Moorhead, Chair of the NHSCC Core Cities Network commented:

The Five Year Forward View calls on CCGs to develop innovative new ways of delivering healthcare – this report demonstrates how commissioners across eight of England’s largest cities are doing just that. It also shows how the knowledge and credibility conferred by local clinically led leadership is key in allowing commissioners to make bold decisions necessary to transform health and wellbeing for their local population.

Key learning points common to many of the case studies are:

• Working closely with partners and maintaining relationships (Community groups, voluntary sector, providers, local authority)
• Collaboration with local authority
• Breaking down boundaries
• Conversations with service users

There are no contact details provided but there is an address at the end of the report you can use if you want to contact any of the CCGs for further information.

The report contains a lot of useful background information and opinion with quotes from commissioners. There is however little insight into real problems faced, or practical steps required to implement the strategies. There are also few outcomes, probably because the initiatives are in the early stages of development so it is a bit early for evaluation to have been undertaken. Hopefully as the projects grow further reports with outcomes will be published.

Conclusion

This report is of interest to commissioners because it gives a snapshot of what commissioners in large cities are doing to deliver healthcare. It defines how clinical commissioning groups in England’s core cities are responding to the challenge set out in the Five Year Forward view, and how they are finding better ways to provide healthcare services.

Commissioners, especially those responsible for commissioning healthcare in large cities can use this to change practice by looking at these case studies and considering if they can adopt some of the ideas in their own areas to find better ways of providing healthcare and in particular look at developing new partnerships with local authorities and providers. Some projects may also be able to be replicated in smaller geographical areas.

Links

Primary paper

NHS Clinical Commissioners. (2015) Transforming healthcare in England’s core cities.

Other references

Limb M. CCGs in eight English cities describe their innovations in tackling health challenges. BMJ, 2015, 351:h5139

NHS England. (2014) Five Year Forward View.

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